Thursday, September 06, 2007

What is the "true" face of birth?

Human beings are not perfect. This is one of the facts that natural childbirth and homebirth advocates don't seem to understand. It is a fundamental corollary of evolution. Human beings, as they exist now, represent the complex interaction between genetic factors and ever changing environments. That's why completely natural occurances, like extended pregnancy, can be deadly.

Let's back up and look at the big picture. If evolution produced optimal human beings, we would all be exactly the same (with the exception of gender). Every woman would be the same height, the same weight, have the same hair color and eye color, get her first period at the same age, etc. etc. That's not the way we are. Every characteristic occurs on a spectrum, and every person is a UNIQUE combination of characteristics.

Moreover, every place on the spectrum of a particular characteristic is NOT equally good. We know that being obese is bad for your health, even though you may become obese because you listen to the natural cravings of your body and eat high fat, high sugar foods.

In addition, what is good in one environment is bad in another. Light skin and blond hair seem confer advantages in cold climates, allowing greater production of vitamin D in response to sunlight. Light skin and blond hair are not helpful in tropical climates, and actually increase the risk of melanoma, a deadly skin cancer.

My point, and it is a critical point, is that "nature" produces the entire range of every characteristic, but a lot of what "nature" produces is maladaptive or outright harmful. Keep in mind that I am not talking about pathological events here. It is not pathological to have light skin and blond hair. It is perfectly normal. Nonetheless, it increases the risk of deadly skin cancer.

Simply put, just because it occurs naturally does not mean that it is advantageous or even healthy.

Length of gestation is subject to genetic and environmental influences. The entire range of possible gestational lengths occus NATURALLY. However, many gestational lengths are maladaptive and harmful. Many women have premature labor and if the labor is not stopped the baby will die. Similarly, many women will not go into labor until 42, 43, or 44 weeks. Some of those babies will die because their nutritional requirements outstrip the capacity of the placenta to provide them.

One of the many nonsensical notions behind natural childbirth advocacy and homebirth advocacy is the idea of "trusting" birth. Not only is "trusting" birth a form of pretending, it betrays a fundamental misunderstanding of evolution. Birth is NOT and can never be trustworthy because evolution is not and can never be trustworthy. Women are not "designed" to give birth. They are not "designed" at all. Existing women are the SURVIVORS that remain after countless maternal deaths and even more neonatal deaths.

Evolution does NOT mean that we will all live through the process of birth. It means that only some of us are capable of surviving the process of birth. Evolution does NOT mean that babies will survive childbirth. It only means that enough babies will survive childbirth so that the species can continue.

On a fundamental level, homebirth advocates are living in a dream world. Take the title of Rixa's blog, The True Face of Birth. The true face of birth includes faces of dead women contorted in a rictus of agony, because that's they way they looked when they died after three days of obstructed labor. Haven't seen that lately? That's because you live where modern obstetrics is available. Literally no one in industrialized countries dies from obstructed labor anymore, but that's the true face of birth.

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